Del Gaudio, N.; Ferrao Santos, S.; Raftopoulos, C. Modified Vertical Parasagittal Sub-Insular Hemispherotomy—Case Series and Technical Note. Brain Sci.2023, 13, 1395.
Del Gaudio, N.; Ferrao Santos, S.; Raftopoulos, C. Modified Vertical Parasagittal Sub-Insular Hemispherotomy—Case Series and Technical Note. Brain Sci. 2023, 13, 1395.
Del Gaudio, N.; Ferrao Santos, S.; Raftopoulos, C. Modified Vertical Parasagittal Sub-Insular Hemispherotomy—Case Series and Technical Note. Brain Sci.2023, 13, 1395.
Del Gaudio, N.; Ferrao Santos, S.; Raftopoulos, C. Modified Vertical Parasagittal Sub-Insular Hemispherotomy—Case Series and Technical Note. Brain Sci. 2023, 13, 1395.
Abstract
(1) Background: Hemispherotomy is the generally accepted treatment for hemispheric drug resistant epilepsy (DRE). Lateral or vertical approaches are performed according to the surgeon's preference. Multiples technical variations have been proposed since Delalande first described his vertical technique. We propose a sub-insular variation of the vertical parasagittal hemispherotomy (VPH) and describe our case series of patients operated on with this procedure. (2) Methods: a continuous series of patients operated on by the senior author (CR) with the modified sub-insular VPH was retrospectively analyzed. We report the demographic pre-operative characteristics, epilepsy and functional outcome as well as the surgical complications.(3) Results: Twenty-five patients were operated on between August 2008 and August 2023, twenty-three of them have at least a 3-month follow-up. On this last group 86,3% of patients were seizure-free. Only two patients developed post-operative hydrocephalus (8.7%), all patients with autonomous preoperative walk and 86,3% of the total series were able to walk without assistance (86.3%) and perform adapted social activities at last follow-up.(4) Conclusion: The modified vertical parasagittal sub-insular hemispherotomy is a successful surgical technique for hemispheric DRE with seizure freedom rates similar to the biggest series reported in the literature. Compared to other series, patients operated with our modified technique had a lower rate of postoperative hydrocephalus and excellent long-term motor and cognitive outcome.
Medicine and Pharmacology, Neuroscience and Neurology
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